Managing diabetes: Medication side effects

By Jenilee Matz, MPH Sep 27, 2022 • 7 min

Diabetes medications are essential to helpkeep blood sugar in control. But as with any medication, these medications come with possible risks and side effects. Thankfully, many side effects from diabetes medications can be temporary, manageable or preventable. 

Why do side effects happen?

All medications come with a risk of side effects, and some are more common than others. Since not all people respond to medication the same way, it's tricky to know if you'll experience side effects. It can depend on how your body absorbs the medication. Other factors, such as age, gender, allergies, additional medications and dietary supplements, can also affect your risk of side effects. 

Side effects and diabetes medications

When you're prescribed a new medication for diabetes, ask your healthcare provider what side effects to watch for and which warrant a need for medical attention. Do not stop taking any medication unless directed by your provider. 


All people with type 1 diabetes and some people with type 2 diabetes need to take insulin. It may be taken by an injection, either through a syringe, insulin pen or insulin pump that's connected to your body. Possible side effects include:

  • A reaction at the site on your skin where you receive the injection.Rotation of the injection site helps reduce irritation and bruising, as well as improves absorption. It is important to give your mealtime insulin in the same general area every day, such as your leg before breakfast and your abdomen before dinner. Hard lumps or extra fatty deposits can form under the skin if you administer insulin too close to the same spot too often. Not only are these problems unsightly, but they can also make insulin less effective. 
  • Low blood sugar. Insulin brings high blood sugar levels down, but taking too much or not balancing insulin with your diet or physical activity can cause your blood sugar levels to drop too low. This can make you irritable, jittery and sweaty. Low blood sugar is dangerous and requires prompt treatment. If you have low blood sugar, follow your treatment plan as prescribed by your healthcare provider.

Oral diabetes drugs

Many people with type 2 diabetes need to take oral diabetes medications to help keep blood sugar levels under control. Possible side effects for the different medications are outlined below: 

Drug class

Drug name 

Possible side effects


Glipizide (Glucotrol), 

Glipizide extended release (Glucotrol XL),  

Glyburide (Diabeta, Glynase, Micronase), 

Glimepiride (Amaryl) 

Low blood sugar, weight gain, skin rash


Repaglinide (Prandin), Nateglinide (Starlix)

Low blood sugar, weight gain 


Metformin (Glucophage), Metformin extended release (Glumetza, Glucophage XR, Fortamet) 

Nausea, diarrhea, upset stomach, loss of appetite


Pioglitazone (Actos), Rosiglitazone (Avandia)

Weight gain, swelling or fluid retention, increased risk of developing or worsening heart failure, heart attack, bone breaks 

Alpha-glucosidase inhibitors

Acarbose (Precose),  

Miglitol (Glyset)

Stomach pain, gas, diarrhea 

Dipeptidyl Peptidase-4 (DPP-4) inhibitors

Sitagliptin (Januvia), Linagliptin (Tradjenta), Saxagliptin (Onglyza), Alogliptin (Nesina) 

Diarrhea, upper respiratory tract infections, sore throat

Bile acid sequestrants 

Colesevelam (Welchol)

Gas, nausea, constipation 

Dopamine-2 agonists

Bromocriptine quick release (Cycloset) 

Nausea, weakness, constipation, dizziness

Sodium-glucose cotransporter-2 (SGLT2) inhibitors 

Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), ertugliflozin (Steglatro)

Urinary tract and vaginal yeast infections 

Other injectable medicines

Some people with type 1 or type 2 diabetes need to take injectable drugs other than insulin to help control blood sugar. Possible side effects for the different medications are outlined below: 

Drug class

Drug name

Possible side effects

Amylin analog

Pramlintide (Symlin)

Low blood sugar, nausea, vomiting, headache, stomach pain

Glucagon-like peptide-1 (GLP-1) receptor agonists

Abiglutide( Tanzeum), Dulaglutide (Trulicity), Exenatide (Byetta), 

Exenatide extended release (Bydureon), 

Liraglutide (Victoza), Lixisenatide (Adlyxin), semaglutide (Ozempic, Rybelsus)

Nausea, vomiting, headache, dizziness, increased risk of pancreatitis

Coping with minor side effects

Talk to your healthcare provider if you have unexpected or bothersome symptoms. They can help you determine if your symptoms are side effects of your medicine or are caused by something else. Your provider or pharmacist can offer suggestions to manage the side effects. Your provider may also decide to lower your dose, switch you to another diabetes medication or suggest changes to your diet or lifestyle to help you feel better.

Taking medications exactly as directed may lessen or eliminate some side effects. For example, some medications need to be taken with food or else they may upset your stomach. If your medicine causes modest weight gain, following the other parts of your treatment plan, such as eating a healthy diet and exercising regularly, can help you maintain your weight. Using the correct dose of insulin can help reduce the risk of low blood sugar, and rotating the injection site can help lower the risk of skin reactions at the injection site.

A word on serious side effects

Though rare, dangerous side effects can occur from taking a medication. Keep in mind that your healthcare provider prescribes medicine when they feel the benefit of taking a drug outweighs the risk of not taking it. If you're taking a medication where a serious side effect is a risk, let your provider know if you have any unusual symptoms. If your symptoms are concerning, seek medical help right away.

Clinically reviewed and updated March 2022.

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